Welcome to Inside Health, where we aim to provide you with expert support
on the health issues that affect all of us and also give you some practical tips
and advice to take away too. Today's topic is something that I think affects all
of us at some point in our lives and that is sleep. So whether you are juggling
work and family, dealing with an illness, coping with stress, going through
menopause, adjusting after retirement, or have a newborn, there are things
always getting in our way during life that can impact on our ability to get a
good night's quality sleep.
In fact, in a recent people customer survey, over 90% said that they don't get
good quality sleep and only 2% said they get more than eight hours a night.
So we know that it really is a big issue.
Let me give you a flavour of what's coming up today. First, I'll be joined by
Amy Gallagher, who's a Senior Sleep Physiologist at the Cromwell Hospital.
I'll be starting off by chatting about why sleep is so important. Amy will then
give us some top tips on good sleep behaviours and what we can all do to
reset our bedtime habits to help get us into a good sleep routine. I'll then be
joined by Professor Jason Ellis for a fascinating conversation on
understanding sleep more deeply and getting the answers that we all really
need to know. And finally, we'll be answering some of your questions that
have been submitted ahead of today's show. So lots to fit in.
So Amy, really great to have you here today to unpack this key topic. You and
I speak to people about their sleep all of the time. It's really common that
people have issues and it can be so debilitating when people are not
sleeping, whether that is a one-off period of a sleep issue or a sort of longer
standing sleep condition. So let's start by, I think, digging into why is sleep so
important? What types of things are happening when we're asleep?
So there's actually quite a lot of changes that occur during our body while
we're sleeping. So it's a total body experience and it's an active process. So
starting from the head we have obviously when our eyes close we start to
progress through different stages of sleep. And as this starts to happen, our
body experiences changes in our heart rate, in our respiratory rate and also in
our muscle as well. So our muscle relaxes throughout the body. We then
have sort of changes in our hormonal regulation as well. So sleep is
responsible for regulating certain hormones and these are all associated then
with things like immunity, cell regeneration, muscle repair. And then we also
have our memory consolidation. So our memory consolidation occurs as a
result of changes in our brainwave activity. So it's very important.
So many things going on and what's really fascinates it's different phases of
sleep or different stages of sleep. There are different things that happen,
It's important to try and get through all of those stages. Are there any physical
consequences of prolonged poor sleep? I mean, does it put us at higher risk
of certain types of conditions?
So unfortunately, yes. So sleep is closely related to a lot of chronic disorders
and diseases as well. So we experience sort of changes in our weight and
also changes in blood pressure. It's associated with worsening of things like
diabetes, it's linked to cancer and also to changes in our mental health and
also things like our skin is impacted, mood is impacted also. So yeah, it's got
quite a large effect on the body.
And what about our mental health then? So how does poor sleep impact on
our mental health?
So it can cause a lot of disruption. So poor sleep is linked to mood changes
and then that reduced focus and concentration throughout the day and over
time that can then result in sort of anxiousness or anxiety sort of increasing.
And that risk of insomnia then also increases as our anxiety risk increases.
Like a like a vicious cycle
It's a vicious cycle. And then with a lack of sleep and that increased anxiety
and changes to our life as a result we can start to experience depression
also. So it's quite a key point of our mental health.
And we talk about having a good night's sleep most people would say that is
as simple as getting eight hours but is it a bit more complex than that?
It is more complex than that. But a good rule of thumb is to aim for seven to
nine hours. So where eight hour sleep is ideal, it's not necessarily possible in
We know from our survey that only 2% of people were getting eight hours or
And it doesn't surprise me, it is unfortunately something that we really need to
focus on and put more attention to and be aware of our sleep patterns and
how we respond to sleep.
And then obviously menopause with what happens in hormones there, we
know that that's very detrimental to sleep. And what about older adults as we
sort of go beyond retirement?
So the menopause is a huge change that women experience and I think
we're gonna speak about that slightly later as well and the changes we can
experience in that. But for the general population, both male female, we
experience a change in our sleep needs so we actually have a reduced need
for sleep and our structure of how our brainwaves change throughout the
night also changes and reduces as we sleep throughout life. So we do
experience those changes. Naps maybe become more common as we often
see older people taking a daytime nap. And then we also have an increased
risk of sleep disorders. So stuff like sleep apnoea or sort of REM behaviour
disorders or restless leg syndrome can all start to impact how we sleep and
how replenish we feel after our sleep.
It tends to feel a little bit doom and gloom, doesn't it? But I know you have
loads of top tips, that are things that we can doYeah.
To improve our sleep. So shall we head through to the bedroom and have a
chat about that there?
So here we are in this beautiful bedroom and for people who don't have a
sleep disorder but have disordered sleep, there are lots of things that we can
do to improve our sleep. And I think sometimes people might hear these
things and think they already know, but if
we're really honest with ourselves, we do develop bad habits over time and it
is really important stuff. So what sort of tips do you have that we can all do to
I guess develop a better sleep routine and have a better chance at getting a
good night's sleep?
So there's quite a lot of steps that we can take towards improving our sleep.
So the first one would be to create a routine. So we wanna be making sure
that we're trying to go to bed at the same time every night and again waking
up at the same time every morning. And where that may seem like how does
that fit in with modern day life and society? It's about adapting what we do
during our waking hours to accommodate that. And that just helps regulate
our circadian rhythm which is our internal clock for sleep.
Does that mean at the weekends you should still be getting up at the same
time you do during the week?
Yes. So where I know a lot of us, myself included, are quite guilty of not doing
that, it is important to try, especially if we're going through a phase of poor
sleep and insomnia like symptoms. We wanna be making sure that we are
being really regimented on our sleep routine.
Okay, we might not want to but it might be the thing that helps. Exactly.
And that's why we've got a little alarm clock here.
And I know that that shouldn't really be next to the bed, should it? Where
should it be?
So ideally we would have it turned around away from the bed so we don't
wanna be watching the clock or the times throughout sleep. So we wanna be
making sure that when we're sleeping we're fully focused on the bed. That
being said, we do all have to wake up in the morning and often if we need to
go to work for earlier than we want to wake up, we definitely need an alarm.
So making sure that we have the alarm within the room where we have to get
up and outta the bed but not directly facing us so it's gonna stimulate us.
And the reason for an old fashioned alarm clock is.
Yes, so we don't want any mobile devices in the room. So here you've got
your mobile phone, there's a laptop.
Can I just put this down on the floor?
Ideally not. So this shouldn't have even entered the room. The bed is not a
place to do work emails. It's not a place to watch any movies or Netflix or TV,
nothing of this work so we want that out of the room.
Well you sleep experts I know say that the bed should only be for sleep and
sex and nothing else.
And the brain recognises that that's what it's for.
Yeah. So we wanna stimulate a routine that is just for resting. So we don't
want to be stimulated by crazy art or loads of different furnishings or lights
coming through the room. So we wanna make sure that our sleep
environment is proactive for sleep.
So what about curtains then? 'Cause there's a lot of light shining through
these curtains that we have here.
Yes. So you just caught me as I was going to highlight that, unfortunately as
lovely as these curtains may be, they're not actually that effective in terms of
our sleep. So the amount of light coming through these, ideally we would
have a blackout blind behind these and that would just prevent light from
infiltrating into the room during our sleep time. So that's one option. We can
also put on an eye mask which a lot of people helps their sleep. But it is best
to try and create the room to be that sleep environment so that we don't need
So it is like making the room like a cave, isn't it? Exactly, yes.
Make it dark, ideally quiet and a bit bland.
Yes, and on top of that as well, we wanna make sure that it's a nice
temperature, so cool. So ideally about 18 degrees celsius, if you can control
the temperature and making sure that we're not completely covered in soft
furnishings which then increase our core body temperature.
So I need to get rid of this lovely cushion as well. Ideally. Pop that off the bed.
How's that done?
Another thing that we are reluctant to get rid of from our room is our lovely
pets. So dogs, cats, rabbits, whatever fluffy friend it is that you have in the
room should not be in the sleep environment.
Why is that?
Because they can distract our sleep. So they cycle through sleep on a
different stage and time as us. So we wanna make sure that there's minimal
distractions within the room.
Should we get rid of that then?
Why don't you chuck that one? So we get rid of this out of the room. Bye-bye
And we can keep them nice and safe in the kitchen. After that then we should
have a nice environment to sleep within.
Okay, so we've got our routine, we've got our nice sleep environment, what
about things we can do for the rest of the day, our lifestyles?
Yeah, so lifestyle factors do start to infiltrate sleep. So coffee in the morning
only. So we shouldn't be having coffee after about two or three in the
afternoon. And for those people who are struggling a lot with sleep, increasing
coffee during the day in order to stay awake and function is actually not a
good treatment plan and eventually it's gonna start to go out of control both
the sleep and the caffeine. So we wanna make sure that you're being careful
and considerate with your caffeine intake.
And alcohol as well. That's terrible for sleep, isn't it?
Yeah, so alcohol is terrible for sleep. A lot of people actually think having a
few drinks might help them fall asleep and that's not exactly true. So it may
help you fall asleep but it definitely won't help you stay asleep or get the sleep
that you require. So it actually suppresses that dream sleep. So it's important
to make sure that we're not drinking too close to bedtime and also making
sure that we're not over drinking.
Okay. Anything else we can do in the day?
Yeah. So exercise as well is a great activity that we can do preferably not
right before bedtime because we'll be almost high off the endorphin. So we
wanna make sure that we're doing it at least a few hours before bedtime.
Eating healthy. So making sure that we're getting our three meals in and then
any snacks as well and trying to avoid high sugar food especially towards
Right, okay. And I've got some earphones here. So I guess the question is, if
you've done all of that and you're still led here at night and you cannot sleep,
what else can you do? I'm guessing it's to use these.
Yes, it is. So unfortunately it's something that we've all most likely
experienced at least once or twice in our life and it's a really unpleasant
experience. But there are things that we can do to try and take the focus off
not being able to fall asleep or initiate sleep. So having something within the
bedroom that you might find relaxing or mindful or encouraging meditation.
So for some people that will be reading the book. So for me personally, I read
my book before bed every night and it works perfectly well. For other people
that could be torturous asking them to keep popping out a book in the middle
of the night. We also don't want it to be a very topical, exciting read because.
Just carry on reading, exactly. With the headphones, they're a good option for
anybody who finds it sort of bedtime stories or sleep podcasts. It can be really
helpful to pop one of those on making sure there's no digital sort of clocks
nearby the bed. So popping on one that's already saved earphones on and
helping yourself to sort of fall into that restful state.
And I know people will wanna know how long? How long should you stay in
bed for and obviously people shouldn't have clocks or have access to time,
but how can they tell when it might be the right time to get up?
So if after... If it's starting to feel anywhere between sort of 15 to 20 minutes,
definitely within the half an hour we should be getting up and heading outside
the room. But obviously that's gonna be how it'll feel because we won't be
looking at our clocks. So
whatever feels like it's been that amount of time and you're really struggling,
then that's a good guide to get up and leave the room.
Okay, so I guess if you're sort of feeling like this is just not happening, sleep is
not happeningYeah, it's not happening, leave the roomGet out.
And concentrate on something else for a bit and try again later.
Well, thank you for that. That's really, really interesting and I think like we said
at the start, if we're really honest with ourselves, there are some things we
might not really want to do in that but they could make a big difference if we're
struggling with our sleep. I think also to add that people who are having
consistently poor night's sleep over a period of time should see their GP
'cause it could beDefinitely.
There's a sleep disorder going on.
And if people have just had a baby... Sorry, can't help you with that one, can
we? No. Hopefully the good will follow, but not initially.
Sleep is such a huge topic and there's new science and data coming out all
the time and it's really fascinating and that's why it's so important that we
have sleep experts who study sleep so that they can help us have a better
understanding as well. And to help us dig a little bit deeper today and get the
latest on those sleep questions that we all want to know more about. I'm
joined by sleep expert professor Jason Ellis. Hi Jason, welcome.
Hi. So I'm really excited for our conversation because there are so many
things that we can discover that are new about sleep and you know about all
of it because you're a sleep expert. So to give people a bit of context about
your sleep credentials, you're a Professor in Psychology at Northumbria
University and Director of the Northumbria Centre for Sleep Research. So
you definitely know your stuff. So for anyone who is struggling with sleep,
hopefully we can answer some burning questions they might have. So let's
start off then with, why is it that some of us struggle to sleep and some people
It's a great first question and I think that we need to think about the biggest
impact on our sleep, which is ageing actually. As we get older, the parts of the
body, the internal system that really regulates our sleep, which is the body
clock, the circadian rhythm, and then there's the drive to sleep, which makes
us more and more tired. Both of those start to degenerate slowly and over
time but they actually do degenerate, which makes us a lot more vulnerable
to not being able to sleep well.
And when you say as we get older, what sort of age does that start to kick in?
It starts around the age of 25, believe it.
I thought you were gonna say 65 or 75. Wow, okay.
It's very small increments, but we are seeing reductions in the amount of
melatonin we produce. For example, the amount of deep refreshing sleep that
we get year on year, they decrease a little bit.
Really interesting. How long can we cope with poor sleep before it starts to
have a significant impact on us?
Well, I think we've all had the odd bad night and the next day we're a little bit
more moody, a little bit more irritable. Probably not gonna use please and
thank you as much. But actually the system can correct itself and it will
correct itself when we start talking about the long-term impact it's poor sleep
over months that we're talking about here.
And that's often down to the environment, isn't it? Now where we have mobile
devices, we're working longer hours and maybe the opportunity to sleep is
not as good as well.
Well, we also got to think about culture. We've got terms that permeate our
culture, snooze you lose, I'll sleep when I'm dead, the value of sleep and its
ability to correct itself actually is lost in that mix.
So if people say have sleep issues for a week or two and then it gets better,
would that be all right or what's the sort of timing?
Generally, if we're talking about stress related sleep problems one to two
weeks, that's a normal adaptive response to the stress. You've got a lot more
cortisol, a lot more adrenaline, and that's just keeping you awake longer just
so that you can try to cope, problem solve, work out solutions. Once we go
over that two week mark, those hormones shouldn't really be impacting our
Okay. Tell me a little bit more about the term sleep anxiety which I've
experienced myself actually, a long time ago, where you persistently can't get
to sleep and then you start to get very anxious about not being able to get to
sleep and the problem sort of gets worse and worse.
The vicious cycle. It's interesting 'cause there's a theory around this that we
start out when we stop losing sleep because of stress, it's because of the
stress. And it could be a positive stressor like a wedding or something nice
but it's still gonna keep us awake. After about two weeks we might see this
switch point where the stressor stops you from sleeping and suddenly the
sleep becomes the stressor itself.
That's what we talk about in terms of sleep anxiety. And there's some really
new research actually came out earlier this year, which demonstrates that is
the single biggest factor, the
sleep anxiety, which makes us go from just a few weeks of sleep disruption to
having chronic insomnia.
Wow. Fascinating. So it's actually then this worry about getting to sleep is the
issue that's preventing the sleep.
It's self perpetuating.
Yeah. I think there'll be lots of people listening to this who are thinking, that
sounds familiar. How do we know when it changes from struggling to sleep so
disordered sleeping to actually becoming a sleep disorder such as insomnia.
So when we generally define insomnia, we're sort of talking about three
months in duration, that's the clinical definition but actually after those two
weeks, something's not quite right and we should be going in and intervening
That's interesting as well 'cause I think a lot of us don't, do we let things get
worse and worse. A lot of people fall asleep fine, but they suffer sleep
disturbance, waking up regularly through the night and struggling to get back
to sleep. What's going on there and what can they do?
So this is part of the entire sleep process. If we think about sleep, we sleep in
90 minutes cycles as adults and during that time we're going through stage
one and that's the point at which we are having that transit between being
awake, being asleep, you know that nodding dog head.
When you're on the train, I get it. Yeah, neither in or out.
Exactly. And then you might experience something like you've stepped off the
pavement too quickly.
Yeah. It's called a hypnic jerk. And what that is, is it's a way of trying to get rid
of any excess energy that you've got creating a nice smooth transit into the
official onset of sleep, which is stage two.
So it's normal then. So that should happen.
It's just you may have experienced it, you have the jump but then you go, ah.
It's a relief, isn't it? You have the jump, you're like, I actually haven't fallen
everything's okay. You take a sigh and then you go to sleep.
That's exactly the passage from being awake in stage one to going into fully
sleeping stage two.
But I don't notice that I always do that. Is it that sometimes I'm not aware or.
It may be sometimes you're not aware you're very sleepy or it might be that
there's not a lot of cortisol left in the system to create the actual physical jump
Okay, fascinating. So interesting. It's 90 minute cycles.
Yes. So we get vulnerable to waking up every 90 minutes. You finish a cycle
before you start the next one. So those create vulnerability points. For most of
us we'll roll over and we'll go back to sleeping, but if something happens, we
need to go for a wee might have a hot flash, our pain medication might be
wearing off or we might indeed have pain. That's enough of a window to
create an actual awakening. Those are normal, they're natural. The issue
becomes can you get back off to sleep after you've dealt with it.
Right. So waking up in the night especially if there's a reason is okay and
that's why you shouldn't start looking at what time it is or stressing about
being awake. You just need to deal with whatever you need to deal with and
just get yourself back off to sleep.
That's exactly the thing that feeds into that sleep anxiety that we're talking
Are some of us just naturally early risers and some of us actually true genuine
night owls? I kind of know the answer to this, but tell us.
Yes, we have something called chronotypes and this is people's performance.
Whether they're really good performing in the morning or good at performing
in the evening. There's a huge amount of people who actually sit in the middle
that we call, intermediate types and they have a lot more flexibility. But what
we see is if we take those people who are very morning oriented, our larks
and we put them into an evening situation, they don't handle it terribly well.
Similarly, if we took somebody who's a real extreme owl and we made them
do stuff in the morning, again, they're not gonna perform as well.
And but there are pros and cons to both are there? So if you are a, well, the
world is really set up for people who function well in the morning, isn't it?
'Cause we tend to have to get up and either go to school or go to work quite
early. But are there some I believe and you can let me know if I'm wrong, that
people like me who are night owls we adapt better to shift work and we adapt
better to jet lag?
Absolutely. So yes, the world is set up and it's all pre-ordained around the
morning, isn't it? It's work time, it's school time, it's getting things ready and
that's part of a culture that we have. Whereas evening's a lot more flexible.
You are absolutely right, there are some benefits around being able to adapt
to changes in your body clock if you're more evening oriented. And so you
have that extra flexibility that might help you work better in a shift work
Well, that makes a lot of sense to me. So I wanted to ask next about the
different stages of sleep. So you mentioned just then about the first stage of
sleep, which is this transition state which can end with the jerk.
So is that stage one?
That's stage one. The actual jerk is the transit into official sleep, which is
stage two. Stage two takes up about half of the whole night. We ignored it for
many, many years but recently we've started to understand that it's got two
main functions for us. The first is it allows us to review the day to determine
what do I need to keep? We expose ourselves to a huge amount of
information, sight, smells, tastes, do we need all that information? Probably
not. So we're determining what do I need, what do I not need so that I can
turn the things I do need into long-term memory later on. The other part of
stage two is what we call, a sensory gating mechanism. It's a posh way of
saying keeping you asleep. So we just use the example of pain. People have
pain or maybe the neighbours they've left the television on or they might be
having a row, it's in our interest to stay asleep and so our brain will actually
create masking so that it says don't focus on that, focus on the sleep, stay
asleep. It actually gates across those sorts of intrusions.
Then we go from that into stages three and four or slow wave sleep. A lot of
people will hear about it in terms of deep sleep. This is where we fix the body,
the immune system. Really this is where it gets its main activation from.
When you're not feeling very well, what do you want to do?
Exactly. Because we want to get the immune system working. The endocrine
system. And that's helping us with our fertility, it's helping us with our eating
behaviour, it's helping us regulate all of those things around insulin that tends
to be also functioning and really efficient during slow wave sleep. The
glymphatic system, and this is one that's quite recent, it's our understanding
that during slow wave sleep we actually clear out toxins in the brain and those
are the toxins that have been associated with things such as dementia.
Wow. So the brain a bit like the lymphatic system of the body, is it then? The
brain's actually cleansing away toxic proteins?
Yeah, pretty much putting a washing machine right way through the system.
We go from stages three and four, slow wave sleep. We actually go back up
to stage two. Check the environment, is it safe to carry on sleeping? Yep. And
then we're allowed to go into REM, rapid eye movement sleep. This is where
we deal with the emotional and the memory side of things. This is where we
regulate our emotions and this is where we consolidate a lot of our memories.
So when we've not had a good night, for example, this is one of the reasons
we are a little bit more moody, a little bit more irritable or we might even get a
little bit more hyper.
Or anxious as well.
Or anxious. Because what's happening during REM is we're putting a cage
around our emotions and dealing with them. Trying to keep them to really a
nice balance so we don't go in either direction.
So stage three then is kind of about the physical body keeping us alive and
healthy and stage four is about sort our psychology sort of keeping us in a
good nick from a mental
health point of view. Which I guess is why we see such close links to poor
sleep, short sleep with conditions like depression and anxiety.
That's because if we're not getting enough sleep at the end, then we're not
able to do that sort of repairing and taking care of ourselves.
Absolutely, it's slightly more complex than that though. Always is, isn't it?
Of course it is. This is why I've got a job. When we're talking about REM, it's
how quickly REM comes in as well. REM should come in at around 90
minutes in that first sleep cycle 'cause it's the end. If it comes in too early, it's
a really good sign that we are likely to become depressed in a few weeks
Wow. God, it's so interesting, Jason, honestly. Anyway, we've gotta move on
to the next question. What about napping? Is napping good for us and if so,
The first thing I would always ask about napping is, why do you need to nap?
If you need to nap, that's generally an indication that there's something wrong
with the quality, the quantity or the timing of the sleep that you're getting. Now
there are occasions where people will need to nap, new moms, chronically ill
people, of course they need to nap. But for the majority of us, why are we
napping? Is it that we're sacrificing sleep somewhere along the way?
So staying up late at night working or having to get up too early.
I mean, napping can be beneficial and certainly in the context of learning. For
example, we might want to ask people to have a nap after they've learned
some information. 'cause it will help them consolidate it, turn it into long-term
memory. But we've gotta keep it short.
Yes. But how long can we nap for before it becomes more detrimental?
We talk about 10 to 20 minutes because after that what tends to happen is
we start a full cycle. And if you think about it, the full cycle's 90 minutes. If you
wake up after 45 minutes, you're gonna have 45 minutes where there's gonna
be a little tension, your body wants to finish the sleep cycle and you've got to
attend to something in the environment. It's what we call sleep inertia. You
know that groggy awful feeling we get?
of feeling worse for it. Yeah.
Okay, that makes sense. What about dreams and nightmares? Are they a
sign of good or bad sleep and is remembering them significant?
Well, it's interesting. We've started to understand a little bit more about
dreams but it's still an area that we don't know an awful lot about. What we do
know is that if you remember a dream you've woken up. So that's the first
indication that it might not be the smoothest transition from being asleep to
being awake. We should be finishing the sleep cycle
perfectly relaxed without being in a particular stage, which should be in that
zone. So if you're remembering dreams, it means that you've woken up
during REM. We know that we have REM dreams throughout the night, but
we can actually dream outside of REM itself. If we are dreaming in black and
white and it's a lot more concrete tied to the world, then it's a non REM
dream. The real fantastical, colourful, beautiful dreams that we have or
horrible nightmares, they're more REM based.
Okay. So if you have a lie in in the morning, which I know we're not really
about to do, but if you do, that's when you have those more concrete dreams.
That's when you probably shouldn't be in bed anymore Absolutely.
And you start sweating often as well.
All making sense. All right, final question. Is there any evidence behind white
noise or brown noise being good for sleep?
There's a lot of anecdotal evidence. Let's describe what white noise is. Have
you ever turned the television on and it's got the shhh in the background?
Yes. Well, not anymore, but back in the older days.
In the old days.
Or if you really wanted to go and listen to your fridge. That low humming
noise. That's white noise.
And then we get lots of different variations which call different colours. So
brown noise, we might think about taking our fridge to the river with us and so
it's got a little bit more depth in it now we've got pink noise, which actually is
more rhythmic. And that's why it's very often used in the context of babies
simulating the womb. Is there evidence? There is some evidence, largely
anecdotal, but there are a couple of studies which have shown that it's quite
beneficial to use white noise in the context of not being able to sleep,
masking out other noises from the environment. The partner who snores, for
example, some people do use white noise effectively.
All those neighbours next door that you're talking about with the loud TV.
It sort of drowns out all the... Okay, Jason, so interesting. Thank you so much.
I could literally sit here and chat to you about this all day. We've covered a lot
of ground there
though, so I think let's go and join Amy again now and we can answer some
of your questions.
So in our final part of today's show, I'm back with Amy and Jason to answer
some of your questions that have been submitted before today's event. So
the first question is, it's one for you Amy, since I hit menopause, my sleep has
really deteriorated. What's the best solution?
So it really depends on what the problem is, so what's causing it? So as we
experience the menopause, we might have a change in weight, we might
increase our snoring threshold and as a result of this we might actually be
experiencing sleep apnoea which can cause excessive daytime sleepiness or
tiredness or just overall dissatisfaction with our sleep quality. We also
experience changes to our mental state. So anxiety, depression, and also a
change in our sleep hormone which may actually be increasing our insomnia.
And also another point to mention is actually our changes in temperature. So
spikes in our temperature which we refer to as hot flushes and whether or not
they're sort of causing sleep arousals as well it's could be a contributor.
So I think that there are so many various different things going on throughout
menopause. It's really trying to find out what they are and finding the
Rather than there being one solution. Thank you. Will sleeping tablets,
melatonin or sleep remedies help me and are there any dangers?
So we prefer natural remedies. So natural remedies in lifestyle factors tend to
have a hugely positive impact on sleep when used correctly and when used
as a combined sort of approach. Medications are available and often have to
be prescribed through our GP and they're often given on a short term sort of
dosage. And the reason for this is because they can become quite reliable.
So we end up almost believing we need these medications to encourage
sleep whereas having them on a short term period allows us to have that sort
of almost placebo effect which can often actually reverse insomnia or
insomnia like symptoms. So it depends and it's again, person by person
And what are some of the more natural remedies that you say you can use
So things as simple as chamomile tea before bed can make a huge change.
Melatonin also. So melatonin is a sleep hormone that's produced within our
body, but again, that should be used correctly and safely. And so asking a
professional for help in how to balance that within their life can really be of
Okay, alright then. Jason, how effective/accurate are sleep trackers on my
Well if you're a normal sleeper and you don't get anxious about your sleep,
they can be used quite effectively. They're quite accurate actually in terms of
sleep duration. So how long you are actually getting per night. The challenge
comes when we start to look at sleep disorders, they're not terribly accurate
for people with sleep disorders. But also a lot of them telling us information
about what stages of sleep. Well I can tell you that that is not terribly
accurate. We tend to have to use an awful lot of electrodes in our laboratories
to work it out, so we're not really gonna get it from our watches.
Okay. So can give you a reasonably accurate length of time you were asleep,
but not perhaps much more than that?
Okay. Does lack of sleep put me at higher risk of dementia?
Great question. There is an association between short sleep durations for a
long period of time and disrupted sleep and dementia. We think this is
because during slow wave sleep, that deep sleep that we get, we're clearing
out the brain and we're clearing out particular toxins, beta amyloid, which is
largely associated with dementia. Now that's great in the sense that it gives
us an opportunity as well because if we can start to manage sleep, are we
gonna start to manage people getting dementia or at least the pathway.
And I think, many people are very scared of getting dementia. So I think this
information, it's not there to scare us actually it should empower us. I think we
can all make tweaks at least to improve the quality of our sleep and I think
that's quite a motivating factor potentially for people.
Amy, are there some sleeping positions that are better than others?
Simply put, no. So it's quite a common question, how can I improve my sleep
if I sleep on my side, if I sleep on my back? It comes down to each individual.
So obviously if we experience back pain or shoulder pain, we might find a
position comfortable and another position not comfortable. The only time that
it sort of really comes into importance is when we have supine dependent
disorders. So particularly our sleep apnoea where lying on the back actually
increases the number of events that we're having. So how many times we're
having those stoppages of breathing. In those cases we would try and train
the body to sleep in a non supine position.
So that's not on the back. Not on the backOn the side or the front.
Again, it can be on the front. It really comes down to preference and
throughout life our sleep position may change as our body changes also. So
yeah. So not necessarily a perfect position for sleep.
And I once had a tip, I think it was from you Jason, many years ago that you
can strap a tennis ball onto the centre of your back so that if you roll over onto
your back during sleep, you'll automatically shift back onto your side or your
Does that work?
It does, thankfully, due to technology improvements, we actually have what is
now just a band that sits around the waist. It's much less in intrusive and
uncomfortable, but yes, it would be a really good.
I'm old school.
It would be a very good way of preventing that supine sleep for sure.
Jason, this is one for you or you can tell us why. Why do my legs twitch in my
So what tends to happen is that some people have got a problem whereby
they actually have slight twitching in their legs at night and it's called periodic
limb movement disorder. And I happen to be one of those people who suffers
from it. Now I don't actually remember these events and many people who
have them don't remember them, but it does lead you to feel a lot more
fatigued and tired during the day because you've had slight awakenings
during the night. We tend to separate this out from something called restless
leg syndrome, which is more as you're getting ready for bed. Itchy, crawly,
uncomfortable sensations in the legs which prevent you from getting off to
sleep at night. But they are quite joined. Now there are things we can do, we
can go and see our GP, talk to the GP about medication or other options.
And what's interesting I think and a reminder for everybody is that you can be
a professor of sleep and actually we're still affected by these things, aren't
we? As humans, we can still be affected.
You can still also go unnoticed despite your plethora of sleep knowledge. It's
these things can go without being caught until sort of our symptoms take over
and suggest that there is actually a sleep disorder there.
And I guess and yours was only picked up because you volunteered to test
out some new equipment, you were the Guinea pig.
Exactly. I decided to try out the new equipment myself and then my technician
comes and says, "Look at this." And I think, "Well, that's terrible." And then
she tells me it's me so it's okay. We can do something about ourselves.
The next question, for people who work shifts, I have a lot of experience with
that, what can they do to minimise any issues relating to poor sleep?
Of course, shift work is not great for us and the things that we can do to help
minimise it, focus really about our relationship with light, dark and valuing the
time that we sleep. Before the end of a night shift, it's best to try to cool down
with light, not get too much access to light, you'll start to wind the body down
getting ready. When you do get home, don't fall asleep on the sofa, go to bed.
The sofa is a daytime zone. You're gonna have people outside, you're gonna
have noises, the washing machine might be going and let people know that
you are actually on a night shift. Equally, if you're getting ready for a night
shift, getting access to light before the night shift, it's gonna give you that
extra alertness to get through.
Alright, really great tips there. And finally, a very, very, very common problem I
hear about is how can I stop snoring? Or actually often it's how can I get my
partner to stop snoring? I think if we add the answer to that, we would be very
Yeah, it's an interesting one. Snoring, there are a couple of things that make
snoring worse. So if you've had alcohol for example or we use some sleep
medications, they tend to relax the throat and therefore it's more liable to
closing ever so slightly. If there is snoring, it's not to be taken as a trivial thing.
I know in society we tend to do so but actually it's important to go and check
to see whether it is something more severe, obstructive sleep apnoea, which
would need treatment. And there are plenty of treatments available.
The thing is often the person who's not snoring that is the one whose health
can suffer, isn't it? 'Cause there's always then the having different beds as
well, having a sleep divorce.
Sleep divorce, yes.
To prevent a real divorce.
Yeah, it can make a huge difference and it can increase lots of other things
that in life which then enhance the relationship. So it's not to be feared.
Yeah. Well, Amy, Jason, thank you so much for that and I really hope that
there was some takeaways there that will help you. I think the bottom line
being, we can all make some changes to improve our sleep. So feel
empowered, not afraid.